A cancer patient's decision to die

Brittany Maynard poses with a dog. Image copyright AP

Brittany Maynard says 1 November is the day she will die.

The 29-year-old was diagnosed with terminal brain cancer in January, after suffering from debilitating headaches for more than a year. Following months of treatment, and a progressively worsening prognosis, Ms Maynard decided she had to change course.

"After months of research, my family and I reached a heartbreaking conclusion: there is no treatment that would save my life, and the recommended treatments would have destroyed the time I had left," she writes in an opinion piece for CNN.com.

She adds that as her cancer progresses, it could lead to excruciating pain, despite the strongest palliative medication.

"I could develop potentially morphine-resistant pain and suffer personality changes and verbal, cognitive and motor loss of virtually any kind," she writes.

"Because the rest of my body is young and healthy, I am likely to physically hang on for a long time even though cancer is eating my mind. I probably would have suffered in hospice care for weeks or even months. And my family would have had to watch that."

She and her husband moved from California to Oregon, one of five US states where physician-assisted suicide is permissible. Once she had established residency and proved that she had less than six months to live, she obtained a prescription for life-ending medication.

She says she plans on using it on 1 November, two days after her husband's birthday.

Ms Maynard has shared her story with Compassion & Choices, a nonprofit organisation advocating the passage of euthanasia laws, and began a media campaign, including a YouTube video in which she and her family explain her situation.

At one point in the video, Ms Maynard reaches in to her purse and removes two prescription bottles, presumably for life-ending drugs.

Image copyright YouTube
Image caption Brittany Maynard says in a YouTube video that she plans to die on her own terms

"I know that it's there when I need it," she says.

The video has been viewed more than 5.6 million times.

She says that she feels relief knowing that she has the option to die "on my own terms" - and wants others in her situation to have the same options.

Ms Maynard's campaign has once again stirred debate over the morality of physician-assisted suicide and its prospects for further legalisation in the US.

"Maynard may not go through with her plans on 1 November (statistically, most of those who get end-of-life prescriptions don't use them, though nearly all report feeling peace of mind with the pills in hand)," writes Meghan Dawn in the Los Angeles Times. "But because she shared her decision, all of it, with the world, her legacy will be a crucial contribution to the conversation about how we live - and end - our lives."

Bioethicist Arthur L Caplan says that Ms Maynard's story has the potential to change the way many people - particularly younger Americans - view the issue.

"A whole new generation is now looking at Brittany and wondering why their state does not permit physicians to prescribe lethal doses of drugs to the dying," he writes for NBC News. "Brittany is having and will have a big impact on the movement to get measures before voters or legislators."

The ground on which the physician-assisted suicide debate rests could quickly shift, he says, much as it did on the gay marriage.

Matt Walsh, writing in the Blaze, agrees that Ms Maynard is "a very compelling spokeswoman for suicide". He says, however, that he is concerned by the almost universal praise she has received in the press and social media for her bravery and poise.

"I am terrified to think that my children will grow up in a culture that openly venerates suicide with this much unyielding passion," he writes. "If you are saying that it is dignified and brave for a cancer patient to kill themselves, what are you saying about cancer patients who don't?"

Several people with terminal diagnoses have also come forward to offer a critical take on Ms Maynard's decision.

"The hardest part of a terminal diagnosis is not knowing the timeline," writes Maggie Karner, who has also been diagnosed with aggressive brain cancer.

She says, however, that public policy on physician-assisted suicide shouldn't be centred around "hard" cases like hers and Ms Maynard's. The power of life and death should remain in God's hands, she writes.

"Death sucks," she says. "And while this leads many to attempt to calm their fears by grasping for personal control over the situation, as a Christian with a Savior who loves me dearly and who has redeemed me from a dying world, I have a higher calling. God wants me to be comfortable in my dependence on Him and others, to live with Him in peace and comfort no matter what comes my way."

Kara Tippetts, who has written a book and blogged about her experience with terminal breast cancer, penned an open letter to Maynard in which she asks her to reconsider her decision.

"Suffering is not the absence of goodness, it is not the absence of beauty, but perhaps it can be the place where true beauty can be known," she writes. "You have been told a lie. A horrible lie, that your dying will not be beautiful. That the suffering will be too great."

She says that doctors who prescribe life-ending medication "walk away from the Hippocratic oath that says 'first, do no harm'."

She concludes: "I get to partner with my doctor in my dying, and it's going to be a beautiful and painful journey for us all. But, hear me - it is not a mistake - beauty will meet us in that last breath."

Under Oregon's 1997 Death with Dignity Act, 1,173 people have requested prescriptions for life-ending drugs, and 752 have used them, according to state records.

Ms Maynard says she plans to record video testimony for the California legislature, which is considering a similar physician-assisted suicide law.

If events transpire as planned, her message to the lawmakers likely will be delivered posthumously.

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